| NPI | 1013969401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60529250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35093040) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-03-01 |